Chinese Journal of Blood Purification

Chinese Journal of Blood Purification ›› 2025, Vol. 24 ›› Issue (09): 737-741.doi: 10.3969/j.issn.1671-4091.2025.09.004

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Predictive performance of whole-blood cell-derived inflammatory markers for all-cause death in maintenance hemodialysis patients

YANG Bin, YANG Yi-nan, GU Xiao-hong, ZHAO Qing-qiong   

  1. Department of Nephrology，The Second Affiliated Hospital of Guizhou University of Chinese Medicine, Guiyang 550000, China; 2Center of Blood Purification，Hongyan District, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang 550003, China
  • Received:2024-11-25 Revised:2025-06-27 Online:2025-09-12 Published:2025-09-12
  • Contact: 550003 贵阳，2贵州中医药大学第二附属医院红岩院区血液净化中心 E-mail:hh01234_01234@163.com

Abstract: Objective  To investigate the predictive value of whole blood cell-derived inflammatory indicators for all-cause mortality in maintenance hemodialysis (MHD) patients.  Methods  A total of 335 MHD patients from January 2022 to December 2022 at Guizhou University of Traditional Chinese Medicine Second Affiliated Hospital were included. They were divided into a deceased group (n=53) and a survival group (n=282) based on follow-up outcomes. Levels of inflammatory indicators were compared between groups. Restricted cubic splines (RCS) and logistic regression analyzed associations between inflammatory indicators and mortality risk. Receiver operating characteristic (ROC) curves assessed predictive value.  Results  Patients in the deceased group had higher neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), neutrophil-monocyte to lymphocyte ratio (NMLR), systemic immune inflammatory index (SII), systemic inflammatory response index (SIRI), and platelet/lymphocyte ratio (PLR) than those in the survival group (Z=-5.746, -5.275, -5.784, -4.446, -6.087, -2.222; all P＜0.05). RCS showed nonlinear relationships between SIRI, NLR, MLR, NMLR, PLR, and all-cause mortality (χ²=11.480, 20.440, 17.500, 18.830, 13.540, 10.750; P =0.003, ＜0.001, ＜0.001, ＜0.001, 0.001, 0.005). After adjusting for confounders, logistic regression identified NLR (OR=2.324, 95% CI :1.461～3.698, P＜0.001), SII (OR=2.047, 95%  CI :1.365～3.070, P＜0.001), SIRI (OR=1.623, 95% CI :1.080～2.437, P=0.017), and NMLR (OR=2.302, 95%  CI :1.457～3.636, P＜0.001) as independent risk factors. AUCs for predicting mortality were: NLR 0.822(95% CI :0.756～0.888), NMLR 0.822(95% CI :0.756～0.888), SII 0.817(95% CI :0.750～0885), and SIRI 0.814s    (95% CI :0.747～0881).  Conclusion   NLR, NMLR, SII, and SIRI are significantly associated with the risk of all-cause mortality in MHD patients and can effectively predict mortality risk.

Key words: Maintenance hemodialysis, Neutrophil/lymphocyte ratio, Systemic inflammatory response index；Systemic immune inflammatory index

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